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Medicare drug benefit explained.

The Centers for Medicare and Medicaid Services is requiring all health plans serving Medicare patients to include all drugs in six categories on their formularies starting in 2006, when the Part D drug benefit begins. The agency noted that in earlier guidance on the Medicare drug plan, it stated that "a majority" of drugs in these categories--antidepressants, antipsychotics, anticonvulsants, anticancer drugs, immunosuppressants, and HIV / AIDS drugs--would have to be on plan formularies and that beneficiaries should have uninterrupted access to all drugs in those classes. But in training sessions and in answering user calls, "CMS has consistently explained that this meant that access to 'all or substantially all' drugs in these specific categories needed to be addressed by plan formularies," the agency said. "This is because the factors described in our formulary guidance indicated that interruption of therapy in these categories could cause significant negative outcomes to beneficiaries in a short timeframe."
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Title Annotation:POLICY & PRACTICE
Author:Silverman, Jennifer
Publication:Internal Medicine News
Article Type:Brief Article
Geographic Code:1USA
Date:Jul 15, 2005
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